Turn of Mind

A review of Alice LaPlante’s novel for the Los Angeles Times.

Alzheimer’s disease doesn’t seem like a great subject for a page-turner. Affecting 10% of us over 65 and 50% older than 85, it inspires dread in the culture. And yet a page-turner is exactly what Alice LaPlante has crafted with “Turn of Mind,” a novel told from the point of view of a woman with dementia. LaPlante manages to take hold of the aforementioned dread and modulate it, creating a startling range and texture of fear. From agonizing, slow-motion-car-crash moments to the ironic frissons of a good horror movie, she hits every bell.

It helps that the book incorporates a mystery storyline, with the suspense developing partly in the real world, partly in the narrator’s unreliable mind. That narrator is the brilliant, acerbic, kind Dr. Jennifer White, a retired orthopedic surgeon whose life, at 65, has been nothing if not fulfilling. Her husband has passed away, but she has two children living near her in Chicago, a distinguished career behind her and a wealth of experience traveling to places such as Baghdad and St. Petersburg, Russia.

Even as her mind deteriorates, Jennifer is able to look back and savor these experiences, often far more vividly than she can recall what she was doing that morning. At first this capacity, combined with her natural wit and pleasure in her own company, allows Jennifer to keep her spirits up — and her personality intact — even when she can’t recognize her friends, her caregiver Magdalena, or her children. She makes a David Letterman-style list of “Top 10 Signs You Have Alzheimer’s”: “7. Strangers are suddenly very affectionate…. 3. Girl Scouts force you to come over and decorate flower pots with them….”

Her doctor’s taste in art presents a fresh affront to her sensibilities with every appointment.

“I was looking through my notebook this morning,” she muses, “and apparently on some days I still have my parents with me. Magdalena has recorded some long talks I have with them. I don’t remember any of this, of course. But I like the idea very much.”

Jennifer’s smarts also allow her to capture the experience of the disease with uncanny acuity.

As Jennifer deteriorates, though, the amusing or thought-provoking moments give way to an atmosphere of constant fear — fear for Jennifer, and sometimes fear of her. It emerges that her longtime best friend and neighbor Amanda has been murdered and the fingers removed from one of her hands. The grisly, apparently pointless operation happened to be Jennifer’s surgical specialty. Periodic visits from the police punctuate Jennifer’s accelerating decline. As she becomes increasingly childlike, they become more brutal in their questioning. The answer to the mystery seems to be locked away in one of the shutdown parts of Jennifer’s mind, out of her reach and the reader’s.

Amanda herself, unfortunately, remains only half-sketched as a character. She exists solely through Jennifer’s recollections, of course, but Jennifer doesn’t spend enough time recalling her for her to truly come alive. A tough dame, she seems to have been deeply and often quixotically moral, but her psychology is never explored. Her and Jennifer’s husbands are even flatter, but the characterizations of Jennifer’s children are better — one a well-intentioned addict, the other a frighteningly competent business school professor. But they can’t stand up to the endlessly complex Jennifer.

That complexity never fades, even when Jennifer’s narration begins to fall completely apart. The razor-sharp quality of her thoughts, even at their most fragmented, gives her entire ordeal a “Twilight Zone” feel. Up until the final stages of the disease, she still somehow manages to retain the quality of a lone sane person adrift in a world that definitely isn’t.

“I am retired. I have Alzheimer’s. I am in a police station because of my blades,” Jennifer observes at one point. “My mind won’t take me beyond these facts. My diseased mind. Yet I have never felt more alert. I am ready for anything. I smile at my daughter/niece, who does not smile back.”